To the 58th congress of the SIR-Italian Society of Rheumatology Much has been said about prevention and the importance of vaccines, especially as a tool to combat highly prevalent pathologies, morbidity and mortality, particularly in elderly or frail subjects, with chronic pathologies, such as rheumatology, or at high risk of hospitalization. “Rheumatic diseases are diseases in which the development of infection is very frequent – explained Andrea Doria, Head of Rheumatology at the Padua hospital – which are among the leading causes of death in these patients; the rheumatologist must try to prevent them and vaccination is one of the most effective ways of preventing an infection“.
The point about the new tools available for the protection of these patients was made during the symposium “The innovations in vaccination of the rheumatological patient beyond Covid”, realized with the educational contribution of GlaxoSmithKline.
The 2017-2019 National Vaccine Prevention Plan constitutes the reference document which recognizes, as a public health priority, the reduction or elimination of the burden of vaccine-preventable infectious diseases. The Pnpv, in addition to presenting the new National Calendar of vaccinations free of charge offered to the population by age group, contains chapters dedicated to vaccination interventions intended for particular categories at risk (by pathology, by occupational exposure, by occasional events) and identifies some areas action priorities. “There are classic vaccinations such as influenza or pneumococcal vaccinations – continued Doria – but many other vaccinations are now required by doctors and including the last one Covid 19 recommended to all immunocompromised patients. Then also the one againstShingles which is one of the most frequent infections among patients treated with some types of drugs widely used in rheumatology; then there are many other recommended vaccinations such as hepatitis B or meningococcal vaccination ”.
And Herpes Zoster is one of the most risky and disabling pathologies for frail patients. More commonly known as shingles, herpes zoster is the reactivation of the chickenpox virus that affects nerve structures. The virus after causing chickenpox can remain inactive in the nervous tissue for many years and then suddenly awaken. This usually leads to painful chickenpox-like rashes most frequently on only one side of the chest or abdomen, but can spread to other parts of the body as well.
About 1 in 3 adults are at risk in their lifetime. The incidence and severity increase with age, with an increase after age 50, reaching 1 in 2 individuals over 85 years of age.
“We are going through a demographic transition, – explained Paolo Castiglia, coordinator of the Aou vaccine center in Sassari, Department of hygiene – thanks also to the successes in prevention and therapy, the population is aging, and therefore the risk conditions for infectious diseases, for which vaccinations that have been designed for the fragile population of children today are increasingly moving towards the adult population, so although the incidence remains predominant in childhood, the burden of pathology deriving from the elderly population is greater “.
The prevention of Herpes Zoster infection can be carried out effectively and safely through the vaccine. Vaccination has been available for several years in Italy and is provided for in the new National Vaccination Prevention Plan included in the Essential Levels of Assistance (Lea). It is free and recommended for people 65 years of age or individuals at risk, even if younger.
To defend against this pathology, a new weapon is now available: the new adjuvanted recombinant vaccine which in some regions is already available for fragile patients, such as rheumatology. “It is a new recombinant vaccine – continued Castiglia – and therefore does not have the limits that the vaccine available up to now live attenuated both for efficacy, but above all because it could not be indicated for the immunocompromised. Today we have a new weapon against Herpes Zoster both for the immunocompromised and for the immunosenescents, therefore the great elderly “.
Many regions are taking action to make this news available to their citizens: “The Veneto Region – recalled Doria – has just released the news in the Official Gazette, the vaccine is available and can be used in all patients for free and in those with more than 50 years old and in immunocompromised people between 18 and 50 years old. From this point of view, the Veneto Region is leading the way ”, he concluded.
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